Healthcare Provider Details

I. General information

NPI: 1831369438
Provider Name (Legal Business Name): SHELBY ANN NEICHOY PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/11/2008
Last Update Date: 03/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4820 W NEWBERRY RD
GAINESVILLE FL
32607-2249
US

IV. Provider business mailing address

3445 NW 25TH TER
GAINESVILLE FL
32605-2293
US

V. Phone/Fax

Practice location:
  • Phone: 352-373-2116
  • Fax: 352-373-1507
Mailing address:
  • Phone: 352-215-8121
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number23677
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: